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Updated: Aug 21, 2026

Removal and Replacement of Endogenous Ligands from Lipid-Bound Proteins and Allergens
Published on: February 24, 2021
IgE binding to pepsin-digested water soluble and insoluble wheat proteins
M Mesa-del-Castillo1, C Martínez-Cócera, M L Caballero
1Allergy Department, Hospital Clínico San Carlos, Madrid, Spain.
Background:
Positive skin prick tests to wheat are a common finding among atopic patients, but only a minor fraction of these patients show immediate clinical symptoms after wheat ingestion. The aim of this study was to evaluate the allergenicity of wheat proteins after pepsin treatments.
Methods:
Six patients with positive specific IgE and/or skin prick test to soluble wheat proteins and to gluten were studied. Five of them had no symptoms after wheat ingestion and showed a negative oral challenge test. All sera were analysed with extracts obtained after pepsin hydrolysis during different time periods of water-soluble and insoluble wheat proteins by IgE immunoblotting.
Results:
A pepsin-sensitive allergen of around 35 kDa was recognized by the five atopic negative wheat oral challenge patients in the undigested water-insoluble extract. A patient showing immediate urticaria after wheat ingestion detected a pepsin-resistant allergen with similar molecular weight. Finally, an inhalation-induced asthma patient recognized water-soluble proteins (of around 14 kDa) that could correspond to the alpha-amylase inhibitors.
Conclusions:
Our immunoblotting method shows better correlation with the clinical symptoms than skin prick test and CAP results. Pepsin resistance of the acetic acid-soluble wheat proteins may be responsible for the immediate symptoms of the patient who presented immediate urticaria.
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